The initial diagnosis and management of Parkinson’s disease

Waller, Sophie; Williams, Laura; Morales‐Briceño, Hugo; Fung, Victor S.C.

doi:10.31128/ajgp-07-21-6087

Cited by 16 publications

(26 citation statements)

References 15 publications

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“…In early disease, although non-motor symptoms may be present and often precede diagnosis, levodopa-responsive motor symptoms predominate, and most patients are effectively managed with oral medications. 1 Motor fluctuations become prominent in mid-stage Parkinson's disease; the therapeutic window narrows, and patients may be considered candidates for deviceassisted therapies (Figure 2; Table 1). Surviving patients enter late-stage Parkinson's disease (LSPD), where there is a shift to increasing disability from non-motor symptoms unresponsive to levodopa (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…Proactive management (Table 3), including enemas if necessary, aims to maintain 1-2 soft bowel motions per day. 1 In those receiving levodopa carbidopa intestinal gel or enteral feeding, macrogol may be administered through the gastric port following training with a specialist neurology nurse or dietitian. Progressive dysphagia affects nutritional status and can cause aspiration pneumonia and distress.…”

Section: Late-stage Parkinson's Disease and The Gastrointestinal Tractmentioning

confidence: 99%

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Challenges in managing late-stage Parkinson’s disease: Practical approaches and pitfalls

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Section: Late-stage Parkinson's Disease and The Gastrointestinal Tractmentioning

confidence: 99%

Challenges in managing late-stage Parkinson’s disease: Practical approaches and pitfalls

et al. 2022

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“…Currently, drugs that treat PD clinically are divided into three categories: direct supplementation of exogenous DA precursors such as levodopa, DA receptor agonists such as pramipexole, and monoamine oxidase B inhibitors such as selegiline. Among these, levodopa is the best option [ 99 – 101 ]. However, although these treatments are initially effective, they present many problems, such as low tolerance and long-term effects.…”

Section: The Nlrp3 Inflammasome: a Target For Novel Therapeutic Appro...mentioning

confidence: 99%

NLRP3 Inflammasome-Mediated Neuroinflammation and Related Mitochondrial Impairment in Parkinson’s Disease

Han

2023

Neurosci. Bull.

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Parkinson’s disease (PD) is a common neurodegenerative disorder caused by the loss of dopamine neurons in the substantia nigra and the formation of Lewy bodies, which are mainly composed of alpha-synuclein fibrils. Alpha-synuclein plays a vital role in the neuroinflammation mediated by the nucleotide-binding oligomerization domain-, leucine-rich repeat-, and pyrin domain-containing protein 3 (NLRP3) inflammasome in PD. A better understanding of the NLRP3 inflammasome-mediated neuroinflammation and the related mitochondrial impairment during PD progression may facilitate the development of promising therapies for PD. This review focuses on the molecular mechanisms underlying NLRP3 inflammasome activation, comprising priming and protein complex assembly, as well as the role of mitochondrial impairment and its subsequent inflammatory effects on the progression of neurodegeneration in PD. In addition, the therapeutic strategies targeting the NLRP3 inflammasome for PD treatment are discussed, including the inhibitors of NLRP3 inflammatory pathways, mitochondria-focused treatments, microRNAs, and other therapeutic compounds.

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“…17 S1) by the first motor symptoms. 15,19,20 According to the diagnostic criteria, slowness of initiation of voluntary movements with progressive reduction in speed and amplitude of repetitive actions (bradykinesia) combined with at least one additional symptom, i.e., muscular rigidity, rest tremor, or postural instability, are the prerequisite for the definite diagnosis. 20 These issues promote the need for the development of new diagnostic techniques.…”

Section: Introductionmentioning

confidence: 99%

Nacre-Inspired MXene Nanocomposite-based Strain Sensor with Ultrahigh Sensitivity in a Small Strain Range for Parkinson’s Disease Diagnosis

Du,

Liu,

et al. 2023

ACS Appl. Mater. Interfaces

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Nowadays, chronic diseases are the primary threat to public health and are getting younger. By taking the advantages of continuousness, convenience, and real-time response, wearable strain sensors have been given great attention to diagnose chronic diseases via analyzing the patient's health state. However, most physiological signals, such as limb tremor of Parkinson's disease, microexpression, and slight joint movement, are tiny and difficult to be detected. Therefore, the development of strain sensors characterized with ultrahigh sensitivity in a small strain range (ε < 10%) is urgent. Inspired by nacre's hierarchical structure, we have fabricated nacre-mimetic nanocomposites with "brick-and-mortar" architecture by employing polyacrylamide (PAM) and Ti 3 C 2 T x MXene nanosheets through a layer-by-layer (LBL) spin-coating technique. The resultant nanocomposite-based strain sensor exhibits ultrahigh sensitivity in a small strain range (GF = 296.8, ε < 10%), attributed to the bioinspired hierarchical structure and hydrogen bond-enhanced interfacial interactions. In addition, a high reliability, broad working sensing range (453%), short response time (183 ms), skin-like tensile stress (7.2 MPa), and excellent durability (2000 cycles) are also achieved. Due to the ultrahigh sensitivity within a small strain, the reported strain sensor can accurately diagnose and distinguish Parkinson's disease symptoms, including thumb pill-rolling tremor, masked face (microexpression), intermittent shaking of the head, and limb cogwheel motion. This work provides new insights to design strain sensors with high sensitivity for monitoring tiny signals and for disease diagnosis.

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The initial diagnosis and management of Parkinson’s disease

Cited by 16 publications

References 15 publications

Challenges in managing late-stage Parkinson’s disease: Practical approaches and pitfalls

Challenges in managing late-stage Parkinson’s disease: Practical approaches and pitfalls

NLRP3 Inflammasome-Mediated Neuroinflammation and Related Mitochondrial Impairment in Parkinson’s Disease

Nacre-Inspired MXene Nanocomposite-based Strain Sensor with Ultrahigh Sensitivity in a Small Strain Range for Parkinson’s Disease Diagnosis

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